HIV Prevention, Treatment Needed in Prisons: Report

Health experts estimate that 25 percent of people living with HIV in the United States pass through correctional facilities each year. And the percentage of prison inmates who are confirmed to have AIDS is four times higher than in the general population, according to the report, "Male Prisoners and HIV Prevention: A Call for Action Ignored," published in the American Journal of Public Health (2003;93(5):759-763).

Public health advocates see correctional facilities as ideal places to instill HIV prevention messages with the hopes of thwarting HIV transmission among prison inmates and among the general population after inmates are released. Many believe that prisons offer health care professionals an opportunity to get HIV-infected individuals into treatment programs, but one primary and controversial part of HIV prevention is promoting safer sex practices, including using condoms. Currently, only two state prison systems -- Mississippi and Vermont -- and five city and county jail systems -- New York, Philadelphia, San Francisco, Los Angeles and Washington -- make condoms available to male inmates, according to study authors Drs. Ronald L. Braithwaite and Kimberly R.J. Arriola of Emory University's Rollins School of Public Health in Atlanta.

One barrier to an increase in such programs is that there continues to be stigma associated with discussion of HIV/AIDS, particularly in correctional settings where many risky behaviors are not allowed. "Prevention specialists are frequently humiliated and negatively stereotyped by correctional officers," the researchers reported. "Bold and aggressive risk reduction policy action is required by correctional policy makers to advance the health and well-being of incarcerated populations and, ultimately, the community at large," Brathwaite and Arriola said.

Ultimately, only collaboration between inmates, correctional officials, public health officials and community service providers will help "establish a seamless system of prevention and treatment services that transcends prison walls," Brathwaite and Arriola wrote. "Some correctional systems supply released inmates returning to their community with only five days' medication. This is woefully inadequate."

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